Fetal Alcohol. Spectrum Disorders. handbook. A University Center for Excellence in Developmental Disabilities Education, Research and Service

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Fetal Alcohol. Spectrum Disorders. handbook. A University Center for Excellence in Developmental Disabilities Education, Research and Service"

Transcription

1 Fetal Alcohol Spectrum Disorders handbook A University Center for Excellence in Developmental Disabilities Education, Research and Service

2 Center for Disabilities, Department of Pediatrics, Sanford School of Medicine, University of South Dakota 1400 West 22nd Street Sioux Falls, South Dakota or On the web at Via at The development of these materials was supported in part by IDEA Part B Grant #H027A and IDEA Part B Section 619 Grant #H173A from the U.S. Department of Education, Office of Special Education Programs through the South Dakota Department of Education, Special Education Programs. The views expressed herein do not necessarily reflect the views of the Department of Education and should not be regarded as such. The Fetal Alcohol Spectrum Disorders Handbook was developed in part using federal funds through a grant from the South Dakota Council on Developmental Disabilities. Visit the South Dakota Council on Developmental Disabilities on-line at <http:// dhs.sd.gov/ddc>.

3 Table of Contents Welcome FASD FAQs Historical Overview of Fetal Alcohol Spectrum Disorders Characteristics of Fetal Alcohol Spectrum Disorders Diagnostic Criteria for Fetal Alcohol Spectrum Disorders Women and Alcohol Use Prenatal Alcohol Exposure and Brain Development Executive Skills Secondary Concerns Prevention Strategies for Home Introduction to Educational Strategies Evaluations Teaching the Alphabet Eye-Hand Coordination Activities Language Development Teaching Math Teaching Reading Short Attention Span Social Behavior Managing Hyperactivity Managing Behavior Concrete Teaching Methods Classroom Environment Vocational Education On-Line Resources Resources in the Wegner Health Science Information Center Bibliography

4 Welcome The Center for Disabilities, Department of Pediatrics, Sanford School of Medicine at the University of South Dakota provides this handbook to serve as an overview of Fetal Alcohol Spectrum Disorders (FASD). The Center for Disabilities works with others to create opportunities that enhance the lives of people with disabilities and their families through training, services, information, research and community education. delivers activities across the lifespan from a community-based, familycentered and culturally-competent perspective, is South Dakota s University Center for Excellence in Developmental Disabilities Education, Research and Service (UCEDD), is a member of the Association on University Centers on Disabilities (AUCD), and is grant funded with core funding coming from the Administration on Intellectual and Developmental Disabilities (AIDD) with is housed in the United States Department of Health and Human Services (HHS). In addition, the Center for Disabilities is an affiliate of NOFAS (National Organization on Fetal Alcohol Syndrome) which provides education and advocacy on FASD issues and resources for people affected by FASD. The message of NOFAS is No safe time. No safe amount. No safe alcohol. Period. All activities at the Center for Disabilities related to FASD are housed under our NOFAS affiliate called NOFAS- South Dakota (NOFAS-SD). NOFAS-SD provides diagnostic clinics, consultation services, a variety of trainings (inservices, community education, professional development), 1

5 technical assistance, and resources (listserv, publications and through the Wegner Health Science Information Center). Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term that covers a variety of disorders. All FASD are caused by prenatal exposure to alcohol through maternal alcohol consumption. The range and severity of characteristics, developmental difficulties, emotional difficulties, and behaviors seen across the spectrum is vast. It would be nearly impossible for this publication to detail every potential effect of FASD. This handbook is not meant to act as a diagnostic tool, instead this handbook is designed to provide an overview of FASD. In this handbook the reader will find: A Historical Overview of FASD, Characteristics of FASD, Diagnostic Criteria for FASD, A Discussion of Executive Skills - their function and signs of their dysfunction, Secondary Concerns for Individuals with an FASD, FASD Prevention Information, Strategies for Individuals with FASD at Home, Educational Strategies for Individuals with FASD, And Much More. 2

6 FASD FAQS What are Fetal Alcohol Spectrum Disorders (FASD)? Fetal Alcohol Spectrum Disorders (FASD) is an umbrella term used to encompass several clinical diagnoses all of which are the result of prenatal alcohol exposure. The term Fetal Alcohol Spectrum Disorders covers Fetal Alcohol Syndrome (FAS), Partial Fetal Alcohol Syndrome (PFAS), Alcohol Related Birth Defects (ARBD) and Alcohol Related Neurodevelopmental Disorders (ARND). FASD include the wide variety of physical, intellectual, behavioral and developmental effects seen in people who were exposed to alcohol before they were born. In other words, prenatal exposure to alcohol can cause a spectrum of disabilities from very mild to very severe. Whether the effects of prenatal alcohol exposure are mild or severe they are all covered by the term Fetal Alcohol Spectrum Disorders. Fetal Alcohol Spectrum Disorders How many people are effected by Fetal Alcohol Spectrum Disorders? It can be difficult to find a statistic which fully shows the number of people who have an FASD. There a several factors which can affect the statistics used to determine the number of FASD cases. These factors include: the type of study used to generate the number; the under diagnosis of FASD; the lack of a national registry; the stigma of identifying children as having an FASD; and the under-reporting of alcohol use during pregnancy. The National Organization on Fetal Alcohol Syndrome (NOFAS) states that 1 in 100 infants born each year are affected by an FASD. However, studies of students already in school, estimates the number of students with FASD to be 50 per 1,000 students. What is the cost of Fetal Alcohol Spectrum Disorders? When discussing the costs associated with FASD, it is important to remember that no dollar amount can begin to express the costs to the individuals with an FASD. The FAS PFAS ARBD ARND 3

7 costs (emotionally, physically, socially, etc.) of a disability on the life of a person and their family is immeasurable. The estimates for the monetary cost of FASD vary and increase over time. In 2009, the annual cost of Fetal Alcohol Syndrome alone was estimated at $3.6 billion in the United States. A study in Canada placed the cost of FASD at $5.3 billion in that country. The National Organization on Fetal Alcohol Syndrome (NOFAS) estimates that the cost of FASD in the United States is $6 billion annually. NOFAS estimates the cost of treatment for one person with Fetal Alcohol Syndrome to be $1.4 million across their lifetime. Based simply on cost, it is clear that FASD is a major public health problem (Riley, 76-77). Is there a cure for Fetal Alcohol Spectrum Disorders? No. The effects of prenatal alcohol exposure are irreversible. Individuals with an FASD and their families deal with the effects of the disorder by managing the behaviors it causes and addressing the medical implications of the disorder. An individual born with an FASD will always have the disorder. Do all people with a Fetal Alcohol Spectrum Disorder have an intellectual disability? No. While FASD are the leading known preventable cause of intellectual disabilities, not all people with an FASD have intellectual disabilities. The IQ of individuals with an FASD can range from 29 to 140. However, IQ is not an indicator of how well a person can perform daily life skills. FASD are a leading cause of learning disabilities which may or may not occur with an intellectual disability. Do Fetal Alcohol Spectrum Disorders affect only certain racial or economic groups? No. FASD are caused by maternal alcohol consumption. FASD affect every segment of the population. All racial/ethnic groups, economic classes, and social strata are affected by FASD. While studies indicate higher rates of FASD in certain groups, it is not due solely to any specific racial or social difference. Is it ever safe to drink alcohol during pregnancy? No. There is no time during pregnancy and no amount of alcohol consumption that is known to be safe. It is even recommended that women stop drinking when they plan to become pregnant. The effects of maternal alcohol consumption on the embryo can occur in even the earliest days and weeks of pregnancy. Can a father s drinking cause Fetal Alcohol Spectrum Disorders? There have been no studies that show a physical link between a father s drinking 4

8 alcohol and FASD. However, a mother s drinking behaviors can be influenced by the drinking behaviors of those around her including her partner. A partner can have a positive or negative effect on a mother s drinking behaviors during her pregnancy. A supporting non-drinking environment can be a great help to a pregnant woman who is avoiding alcohol during pregnancy. If a person with a Fetal Alcohol Spectrum Disorder has children, will their children have a Fetal Alcohol Spectrum Disorder? No. FASD are not genetic disorders. FASD only occur when an embryo or fetus is exposed to maternal alcohol consumption during pregnancy. Women with an FASD can have children without FASD by not consuming alcohol during their pregnancy. What are the most important things to remember about Fetal Alcohol Spectrum Disorders? FASD are a wide spectrum of disabilities caused by prenatal exposure to alcohol. FASD are the leading known preventable cause of birth defects and intellectual disabilities. FASD affect more children than Autism, Down Syndrome, cerebral palsy, cystic fibrosis, spina bifida, and sudden infant death syndrome combined. FASD can affect anyone. FASD are not genetic disorders. There is no time during pregnancy when drinking alcohol is safe. There is no safe amount of alcohol to drink during pregnancy. FASD are 100% preventable. 5

9 Historical Overview of Fetal Alcohol Spectrum Disorders Please remember when reading the following that the language used in the past may seem harsh or judgmental but reflects the time period in which it was produced. The history of the recognition of the link between maternal alcohol consumption and disabilities in children seems to stretch back into history. One of the most often quoted historical references is in the book of Judges in the Old Testament which states, in part, Behold, thou shalt conceive, and bear a son: and now drink no wine or strong drink (Judges 13:7). Another is from the Greek philosopher Aristotle who wrote, Foolish, drunken and harebrained women, most often bring forth children like unto themselves, morose and languid (Streissguth, page 35). While these historical references may indicate a knowledge of the dangers of maternal alcohol consumption, it is impossible to know if the ancients recognized a causal relationship between maternal alcohol consumption and difficulties experienced by children. In fact, many experts believe that references such as these might in fact refer to the postnatal effect of maternal alcohol consumption as it relates to the child s environment. The medical profession began to comment on the effects of maternal alcohol consumption as early as the 1700s. During the 1700s in England gin was very inexpensive and resulted in what is known as the gin epidemic. In 1725, the College of Physicians drafted a letter to Parliament detailing their concerns about the rampant consumption of gin. The letter read, in part, that the physicians had observed the fatal effects of the frequent use of several sorts of distilled spirituous liquors upon great numbers of both sexes rendering them diseased, not fit for business, poor, a burthen to themselves and neighbors and too often the cause of weak, feeble, and distempered children [italics Abel s]. (Abel, page 4) By the 1800s, more specific scientific inquiry into the effects of maternal alcohol consumption was undertaken. In 1865, French physician Dr. E. Lanceraux may have even described some of the most noticeable features of Fetal Alcohol Syndrome (FAS). As an infant he dies of convulsions or other nervous disorders; if he lives, he becomes an imbecile, and in adult life bears the special characteristics: the head is small [tendency to microcephalism], his physiognomy vacant [peculiar 6

10 facial features], a nervous susceptibility more or less accentuated, a state of nervousness bordering on hysteria, convulsions, epilepsy... Are the sorrowful inheritance, which unfortunately, a great number of individuals given to drink bequeath their children. (Abel, page 6) Dr. William Sullivan, a prison physician in Liverpool, England, published in 1899 the results of his study of children born to 120 female prisoners who were alcoholics. Women were screened to exclude those who had histories of syphilis, tuberculosis, and other diseases. Sullivan then compared these alcoholics with 28 of their blood relatives who were married to sober husbands and had also given birth to children. Of the 600 children born to alcoholic women, only 44% lived longer than 2 years of age. The other 56% were either stillborn or died prior to 2 years. Compared to the 44% mortality rate among the alcoholic population, the mortality rate among children born to these nonalcoholic blood relatives was 24%. Not only did Sullivan find a stillbirth and infant mortality rate 212 times higher among alcoholic women compared to controls, he also found that women who entered prison early in their pregnancies gave birth to children who were healthier than women who entered prison late in their pregnancies. (Abel 6-7) Despite all the historical references to what could be Fetal Alcohol Spectrum Disorders, it wasn t until late in the last century that scientific study into prenatal alcohol exposure was conducted. Some of the earliest studies were conducted in France. In 1957, a group lead by Dr. H. Heuyer reported that children born to alcoholic parents had a higher than expected incidence of delayed growth and development of neurological disorders. (Abel, 8) Eleven years later Dr. P. Lemoine and his colleagues published a benchmark study of 127 children from 69 families in which alcohol consumption was a significant problem. In 29 of these families both parents were alcoholic; in 25 only the mother was alcoholic; in the other 15, only the father was alcoholic. The researchers found that 25 of the 127 children had four distinctive features: a) unusual facial features including deformed ears, a short, upturned nose with a sunken nasal bridge, and a bulging forehead; b) prematurity and low birth weight, even after correction for prematurity, and postnatal growth retardation; c) malformations, especially those involving the heart and limbs, and cleft palate; and d) delayed psychomotor development and language abilities, hyper-activity, and subnormal intelligence with average I.Q.s of 70. (Abel, 9) Dr. Lemoine and his colleagues had essentially described Fetal Alcohol Syndrome for 7

11 the first time in scientific literature. However, since the article was written in French it was not well read in the United States. In 1973, Dr. C Ulleland a resident at Harborview Hospital in Seattle, Washington noted that six infants in his care with failure to thrive were born to mothers who were alcoholics. Dr. Ulleland brought these six cases, along with others he identified, to Drs. Ken Jones and David Smith who at the time were practicing pediatric dysmorphology at Harborview Hospital. Drs. Jones and Smith recognized in these children a characteristic pattern of facial features that were unlike those of any other condition. At this point, Dr. Ann Streissguth, a child psychologist, was asked to examine the children and found that each had some degree of developmental delay or disability. Drs. Jones, Smith, Streissguth and Ulleland published Pattern of Malformation in Offspring of Chronic Alcoholic Mothers in the journal Lancet. It was in this article that the term Fetal Alcohol Syndrome (FAS) was first used. In the years since the 1973 publication of this article, it has been recognized that FAS is only one part of a spectrum of disorders related to prenatal alcohol exposure due to maternal alcohol consumption. In 1986, the United States Institutes of Medicine, Division of Biobehavioral Sciences and Mental Disorders created a Committee to Study Fetal Alcohol Syndrome. The culmination of the Committee s work was the publication of Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment. It was this book that divided the disorders caused by prenatal alcohol exposure into four diagnostic groups: Fetal Alcohol Syndrome (FAS) [with or without confirmed maternal alcohol exposure], Partial Fetal Alcohol Syndrome (PFAS) [with or without confirmed maternal alcohol exposure], Alcohol Related Birth Defects (ARBD) [requires confirmed maternal alcohol exposure], and Alcohol Related Neurodevelopmental Disorders (ARND) [requires confirmed maternal alcohol exposure]. In 2004, a group of national experts representing the Centers for Disease Control (CDC), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the Substance Abuse and Mental Health Service Administration (SAMHSA), Health Canada and professionals in the fields of research, psychiatry and justice attended a meeting facilitated by the National Organization on Fetal Alcohol Syndrome (NOFAS). At this meeting, the term Fetal Alcohol Spectrum Disorders (FASD) was coined. 8

12 FASD is an umbrella term describing the range of effects that can occur in individuals exposed to alcohol before birth through maternal alcohol consumption. These effects may include physical, mental, behavioral or learning disabilities with possible lifelong implications. Since the description of Fetal Alcohol Syndrome in 1973, professionals in a variety of fields have continued to study the effect of maternal alcohol consumption during pregnancy. They have also worked steadily to better understand the difficulties children who were exposed to alcohol prenatally will face throughout their lives. It is now known with certainty that there is no safe amount of alcohol that can be consumed by a woman during pregnancy and that there is no safe time during prenatal development when the child can be exposed to alcohol without it having an effect. 9

13 Characteristics of Fetal Alcohol Spectrum Disorders There are three main categories into which the characteristics of Fetal Alcohol Spectrum Disorders (FASD) fall - Growth Deficiency, Facial Characteristics and Central Nervous System Dysfunction. It is important to remember that each of the characteristics listed below can be present in any particular individual to varying degrees. Depending on the FASD with which the individual has been diagnosed the following characteristics may not be present. It is not necessary for all of the following characteristics to be present for a diagnosis of an FASD to be made. Growth Deficiency In Height In Weight In Both Height and Weight Occurring either before (prenatal) or after (postnatal) birth Facial Characteristics (Most Notable in Fetal Alcohol Syndrome) Smooth Philtrum (The philtrum are the ridges between the nose and mouth.) Short Palpebral Fissures (Palpebral fissures are the openings for the eye between the eyelids.) Thin Vermillion Border (May be referred to as thin upper lip.) Minor Facial Characteristics Flat Midface Short Upturned Nose Underdevelopment of the Upper Ear (May be referred to as railroad track ears.) Central Nervous System Dysfunction Microcephaly (Small Brain Size) Tremors 10

14 Seizures Hyperactivity Attention Deficits Gross Motor Difficulties Fine Motor Difficulties Learning Disabilities Developmental Delays Intellectual Disabilities Sensory Integration Difficulties Memory Difficulties Difficulty Processing Information Impulsivity Distractibility Difficulty with Abstraction Difficulty Understanding Consequences Fetal Alcohol Spectrum Disorders, especially where there is no confirmed history of prenatal alcohol exposure, are often diagnosed based on the complete set of characteristics in an individual. The effects of FASD can vary in their presentation over the course of an individual s lifespan. The following lists characteristics that may be see in individuals with FASD at different developmental stages. Again, it is important to remember that not every individual will exhibit all of the following characteristics and that the presence of all these characteristics need not be present for the diagnosis of an FASD to be made. Characteristics in Newborns or Infants Difficulty Sleeping (Unpredictable sleep/wake cycle.) Electroencephalogram (EEG) Abnormalities Failure to Thrive Feeding Difficulties including Weak Sucking Reflex Heart Defects 11

15 Kidney Problems Skeletal Anomalies Easily Overstimulated (Increased sensitivity to light and sound.) Neurological Dysfunctions Fine Motor Control Difficulties Gross Motor Control Difficulties Tremors Seizures Small Physical Size Increased Susceptibility to Infections Characteristics in Preschool Aged Children Emotional Overreaction (Tantrums) Hyperactivity Impulsivity Intellectual Disabilities Eye-Hand Coordination Difficulties Physical Coordination Difficulties Poor Judgment (May be expressed as a difficulty recognizing danger including not fearing strangers. May seem overly friendly.) Small Size Speech Delays (May include articulation difficulties, slow vocabulary or grammar development or perseverative speech. Perseverative speech is speech in which a word, phrase or sentence is repeated insistently.) Characteristics in Elementary School Aged Children Attention Deficits Hyperactivity Language Difficulties (Delayed development of language or difficulties with expressive and/or receptive language.) 12

16 Learning Disabilities Intellectual Disabilities Memory Difficulties Impulsivity (May be seen as lying, stealing or defiant acts). Poor Judgment Small Size Social Difficulties (May include immaturity, difficulty making choices, being overly friendly and/or being easily influenced.) Characteristics in Adolescents and Young Adults Difficulties with Abstractions Difficulty Understanding or Anticipating Consequences Low Academic Achievement Low Self-Esteem Memory Difficulties More Pronounced Impulsivity (Often seen as lying, stealing or defiant acts.) Poor Judgment Social Difficulties (May include immaturity, difficulty making choices, being overly friendly and/or being easily influenced.) The characteristics of Fetal Alcohol Spectrum Disorders (FASD) are not only difficulties or deficits. Individuals with FASD often have strengths which can help them overcome their challenges. As before, it is important to remember that not every individual with an FASD will exhibit the strengths listed below. Strengths of Individuals with FASD Highly Verbal Artistic Musical Mechanical Athletic Friendly Generous Outgoing Affectionate Determined Willing Helpful 13

17 Diagnostic Criteria for Fetal Alcohol Spectrum Disorders The Institutes of Medicine published Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention and Treatment in This book provided a diagnostic criteria for all the disorders on the Fetal Alcohol Spectrum. In 2005, the diagnostic criteria was updated with the publication of Practical Clinic Approach to Diagnosis of Fetal Alcohol Spectrum Disorders: Clarification of the 1996 Institute of Medicine Criteria in the journal Pediatrics. This update was written by a group of professionals working in the field of Fetal Alcohol Spectrum Disorders. The following diagnostic criteria is taken from this article. Please consult the article for more detailed information. Fetal Alcohol Syndrome (FAS) with Confirmed Maternal Alcohol Exposure (This diagnosis requires the presence of all features A-D listed below.) A. Confirmed maternal alcohol exposure B. Evidence of characteristic pattern of minor facial anomalies, including at least two of the following 1. Short palpebral fissures 2. Thin vermillion border of the upper lip 3. Smooth philtrum C. Evidence of prenatal and/or postnatal growth retardation 1. Height or weight 10th percentile, corrected for racial norms (if possible) D. Evidence of deficient brain growth or abnormal morphogenesis, including at least one of the follow 1. Structural brain abnormalities 2. Head circumference 10th percentile Fetal Alcohol Syndrome (FAS) without Confirmed Maternal Alcohol Exposure (This diagnosis requires the presence of all features A-C listed below.) 14

18 A. Evidence of a characteristic of minor facial anomalies, including at least two of the following 1. Short palpebral fissures 2. Thin vermillion border of the upper lip 3. Smooth philtrum B. Evidence of prenatal and/or postnatal growth retardation 1. Height or weight 10th percentile, corrected for racial norms (if possible) C. Evidence of deficient brain growth or abnormal morphogenesis, including at least one of the following 1. Structural brain abnormalities 2. Head circumference 10th percentile Partial Fetal Alcohol Syndrome (PFAS) with Confirmed Maternal Alcohol Exposure (This diagnosis requires the presence of all features A-C listed below.) A. Confirmed maternal alcohol exposure B. Evidence of a characteristic pattern of minor facial anomalies, including at least two of the following 1. Short palpebral fissures 2. Thin vermillion border of the upper lip 3. Smooth philtrum C. One of the following other characteristics 1. Evidence of prenatal and/or postnatal growth retardation a. Height or weight 10th percentile corrected for racial norms (if possible) 2. Evidence of deficient brain growth or abnormal morphogenesis, including at least one of the following a. Structural bran abnormalities b. Head circumference 10th percentile 15

19 3. Evidence of a complex pattern of behavioral or cognitive abnormalities inconsistent with developmental level that cannot be explained by genetic predisposition, family background or environment alone a. This pattern includes marked impairment in the performance of complex tasks (complex problem solving, planning, judgment, abstraction, metacognition, and arithmetic tasks): higher-level receptive and expressive language deficits; and disordered behavior (difficulties in personal manner, emotional lability, motor dysfunction, poor academic performance, and deficient social interaction.) Partial Fetal Alcohol Syndrome (PFAS) without Confirmed Maternal Alcohol Exposure (This diagnosis requires the presence of both features A and B listed below.) A. Evidence of a characteristic pattern of minor facial anomalies, including at least two of the following 1. Short palpebral fissures 2. Thin vermillion border of the upper lip 3. Smooth philtrum B. One of the following other characteristics 1. Evidence of prenatal and/or postnatal growth retardation a. Height or weight 10th percentile corrected for racial norms (if possible) 2. Evidence of deficient brain growth or abnormal morphogenesis, including at least one of the following a. Structural bran abnormalities b. Head circumference 10th percentile 3. Evidence of a complex pattern of behavioral or cognitive abnormalities inconsistent with developmental level that cannot be explained by genetic predisposition, family background or environment alone a. This pattern includes marked impairment in the performance of complex tasks (complex problem solving, planning, judgment, abstraction, metacognition, and arithmetic tasks): higher-level receptive and expressive language deficits; and disordered behavior 16

20 (difficulties in personal manner, emotional lability, motor dysfunction, poor academic performance, and deficient social interaction. Alcohol Related Birth Defects (ARBD) (This diagnosis requires all features A-C listed below.) A. Confirmed maternal alcohol exposure B. Evidence of a characteristic pattern of minor facial anomalies, including at least two of the following 1. Short palpebral fissures 2. Thin vermillion border of the upper lip 3. Smooth philtrum C. Congenital structural defects in at least one of the following categories, including malformations and dysplasias (if the patient displays minor anomalies, at least two must be present) 1. Cardiac: atrial septal defects, aberrant great vessels, ventricular septal defects, conotruncal heart defects 2. Skeletal: radioulnar synostosis, vertebral segmentation defects, large joint contractures, scoliosis 3. Renal: aplastic/hypoplastic/dysplastic kidneys, horseshoe kidneys/ ureteral duplications 4. Eye: strabismus, ptosis, retinal vascular anomalies, optic nerve hypoplasia 5. Ears: conductive hearing loss, neurosensory hearing loss 6. Minor Abnormalities: hypoplastic nails, short fifth digits, clinodactyly of fifth fingers, pectus carinatum/excavatum, campodactyly, hockey stick palmar creases, refractive errors, railroad track ears Alcohol Related Neurodevelopmental Disorders (ARND) (This diagnosis requires both features A and B listed below.) A. Confirmed maternal alcohol exposure B. At least one of the following 1. Evidence of deficient brain growth or abnormal morphogenesis including at least one of the following 17

21 a. Structural brain abnormalities b. Head circumference 10th percentile 2. Evidence of a complex pattern of behavioral or cognitive abnormalities inconsistent with developmental level that cannot be explained by genetic predisposition, family background or environment alone. A. This pattern includes marked impairment in the performance of complex tasks (complex problem solving, planning, judgment, abstraction, metacognition, and arithmetic tasks); higher level receptive and expressive language deficits; and disordered behavior (difficulties in personal manner, emotional lability, motor dysfunction, poor academic performance, and deficient social interaction) 18

22 Women and Alcohol Use Any woman is at risk for having a child with a Fetal Alcohol Spectrum Disorder (FASD) when they consume alcohol during pregnancy. There is no safe amount of alcohol that can be consumed during pregnancy and no safe time to consume alcohol during pregnancy. The damage that results from prenatal alcohol exposure can occur when the developing child is either an embryo or a fetus. Many women may consume alcohol in the earliest weeks of their pregnancy - even before they know they are pregnant. About 40% of women at 4 weeks gestation do not realize they are pregnant. This is a critical time for organ development in the embryo and any amount of maternal alcohol consumption can affect the development of the child. In the United States about half of all pregnancies are unplanned and women who are not planning to become pregnant may not realize they are pregnant in the earliest weeks. Therefore it is important for women who are planning to become pregnant or are not using effective birth control to abstain from alcohol use. In a survey conducted between 1991 and 2005 by the Centers for Disease Control, 12.2% (or 1 in 8) of pregnant women reported consuming at least one alcoholic drink in the previous 30 days. This rate remained constant across the entire 15 years of the survey. The pregnant women most likely to report alcohol use were between 35 and 44 years of age (17.7%), were college graduates (14.4 %), were employed (13.7%) and were unmarried (13.4%). It is important to remember that this survey asked women to report their alcohol use and that alcohol use may be underreported. Mothers who are older (30 years old or older) are more likely to drink throughout their pregnancy. Younger women (24 years old or younger) are more likely to binge drink early in their pregnancy sometimes before they even know they are pregnant. Binge drinking is defined as having 4 or more drinks in a period of 2 hours. A drink is 12 ounces of beer, 5 ounces of wine, or 1 ounce of liquor. The maternal use of alcohol in any amount - whether the use is sustained or binge drinking - can affect the development of the unborn child which can result in FASD. It is especially important for women who are sexually active and of child-bearing age to consider the possibility of becoming pregnant and the effect their alcohol consumption could have on their future children. 19

23 Prenatal Alcohol Exposure and Brain Development Alcohol is a teratogen meaning that it is a substance which causes the malformation of cells in the developing embryo or fetus. Alcohol consumed by a woman when she is pregnant passes into the blood stream of the developing baby. The alcohol causes developing cells to be malformed. This malformation of cells affects the brain and its function but also results in the characteristic facial features associated with Fetal Alcohol Spectrum Disorders. Prenatal alcohol exposure can affect both the formation and movement of developing cells. Exposure to prenatal alcohol can disrupt the normal proliferation and migration of brain cells, which produces structural deviations in brain development. Prenatal alcohol exposure can also disrupt the electrophysiology and neurochemical balance of the brain, so that messages are not transmitted as effectively or as accurately as they should be. (Streissguth, 97) The growth of an embryo and/or fetus progresses in an orderly process with development of the central nervous system occurring throughout. Given the vast variety of characteristics exhibited by individuals with a Fetal Alcohol Spectrum Disorder, it stands to reason that the effect of prenatal alcohol exposure on brain development can be influenced by several different variables. Dose, timing and pattern of exposure modify the prenatal effects of alcohol. Animal research has demonstrated that the teratogenic effects of alcohol are not limited to heavy chronic exposure. Moderate alcohol and episodic exposure also produce deleterious effects on offspring, as do exposure both early and late in gestation.... Individual differences in the mother and the child modify the effect of prenatal exposure in the individual animal, in terms of both the severity and the type of offspring effect.... The fact that some offspring appear unaffected by prenatal alcohol at any point in time does not mean that alcohol is not teratogenic or that an individual who is free of alcohol-caused disabilities at one age will necessarily be free of them at another.... Brain damage from prenatal alcohol exposure can occur without accompanying 20

24 physical manifestations and from lower does and frequency of exposure. (Streissguth, 66-67) There are several ways in which researchers study the brains of individuals affected by prenatal alcohol exposure. Autopsies and magnetic resonance imaging (MRI) are used to study damage caused to the structure of the brain. To study the function of various parts of the brain researchers use electroencephalograms (EEGs), positron emission tomography (PET), and functional magnetic resonance imaging (fmri). The five areas of the brain most frequently referred to when discussing the effects of prenatal alcohol exposure are the basal ganglia, cerebellum, corpus callosum, frontal lobes and hippocampus. Neuroimaging studies have shown that all five of these brain regions are decreased in size in the brains of individuals who were exposed to alcohol prenatally. In the worst cases, the corpus callosum may be absent. The impact of damage to the various brain regions is most readily seen by the functions that each of these regions controls. It follows that damage to each of these regions would adversely affect the function for which it is responsible. Basal Ganglia - Memory, time perception, problem solving, time perception and predicting outcomes. Cerebellum - Coordination, balance, movement, behavior, memory and attention. Corpus Callosum - Connects the two halves of the brain. Frontal Lobes - Executive functions, impulse control and judgment. Hippocampus - Learning and memory. When any of these regions - the basal ganglia, cerebellum, corpus callosum, frontal lobes or hippocampus - is damaged by prenatal alcohol exposure it can have devastating effects. Each unique area of the brain, by itself and in connection with the rest of the brain, controls important functions. The greater the damage to the brain, the greater the consequences. It is important to remember that brain damage caused by prenatal alcohol exposure can be present even in the absence of the classic facial characteristics. It is also important to remember that the effects of prenatal alcohol exposure are irreversible but are 100% preventable. 21

25 Executive Skills Executive skills (sometimes referred to as executive functions) are those processes which allow an individual to manage themselves and their resources in order to achieve a goal. These are high level cognitive functions which allow individuals to organize their behavior through planning and organizing, sustaining attention, persisting to complete a task, managing emotions, and monitoring thoughts to work more efficiently. Executive skills have been defined as the directive capacities of the mind which cue the use of other mental abilities. These skills are controlled by the frontal lobes of the brain. The brain damage caused by prenatal alcohol exposure can affect the frontal lobes of the brain which in turn causes executive dysfunction. Inhibition Inhibition is the ability to stop yourself from responding to distractions and to think before acting. The ability to resist the urge to say something. The ability to delay gratification now for more important, long-term goals. Possible Signs of Dysfunction of the Executive Skill of Inhibition Easily Distracted Impulsive Interrupts Chooses smaller, immediate reward over a larger, delayed reward. Gives up quickly on difficult or challenging tasks. Begins task without having listened to or read all the instructions. Answers questions quickly and then changes their answer. Talks back. Difficulty waiting for their turn. Flexibility Flexibility has two components. The first is the ability to move from one situation or task to another without difficulty. The second is the ability to respond appropriately to the new situation or task. Possible Signs of Dysfunction of the Executive Skill of Flexibility Persists in one approach to a situation/problem. 22

26 Unable to explore multiple approaches to a problem or task. Difficulty with open-ended questions or tasks. Becomes easily frustrated with changes in plans, routines or situations. (Younger children may exhibit temper tantrums when faced with a change of situation or task.) Difficulty adjusting when directions for a task change during the task. Emotional Control Emotional control refers to the individual s ability to manage their emotions. It is important to be able to control emotions so that rational thoughts and actions can be used to approach situations and tasks. Possible Signs of the Dysfunction of the Executive Skill of Emotional Control Exhibits inappropriate reactions to situations/tasks. Over-reacts to situations/tasks. Easily frustrated when tasks become challenging. Displays emotions that may be inappropriate for the situation. Makes negative statements about the situation/task. Anxious at a level inconsistent with the situation/task. Slow to recover from disappointments. May exhibit tantrums, mood changes or outbursts of temper. Initiation Initiation is an individual s ability to begin a task or activity independently. Initiation also involves the ability to generate ideas, responses or problem-solving strategies. Possible Signs of the Dysfunction of the Executive Skill of Initiation Difficulty getting started with tasks. Needs reminders to get started on tasks. Slow to move from completed task/activity to the next task/activity. May need to be reminded of schedule, even if the schedule has been in place for some time. Waits for another member of a group to initiate group activities. Working Memory Working memory is necessary for an individual to hold information in their memory while completing a task or activity. Possible Signs of the Dysfunction of the Executive Skill of Working Memory Unable to follow directions. 23

27 May forget the process for completing a task. Difficulty remembering to perform tasks that they are responsible for completing on a regular basis. Forgets to turn in school assignments or to complete assigned tasks. Difficulty remembering instructions given verbally. Asks to have instructions repeated. Stops while performing a task and must be prompted to resume work. Loses or misplaces items. Planning Planning refers to the ability to determine the steps which must be completed in order to accomplish a task. Planning also refers to the ability to place the steps needed to complete a task in the correct order. Possible Signs of the Dysfunction of the Executive Skill of Planning May start a task without the necessary materials. Skips steps while completing a multi-step task. Difficulty relating stories sequentially/chronologically. May not leave enough time to complete a task or may create an unrealistic timeline. Difficulty completing long-term tasks. May be unable to effectively organize group activities. Difficulty focusing on the most important information necessary to complete a task. Organization Organization is the ability to obtain and maintain necessary materials to complete a task. Possible Signs of the Dysfunction of the Executive Skill of Organization Loses objects important for the completion of a task. May fail to complete assigned tasks. Difficulty maintaining a neat workspace (messy). May have difficulty writing in an structured manner. Time Management Time management refers to an individual s ability to estimate lengths of time, allocate time effectively, stay within timelines and meet deadlines. 24

28 Possible Signs of the Dysfunction of the Executive Skill of Time Management Difficulty completing tasks to meet a deadline. May focus on small tasks instead of completing steps toward completion of larger long term tasks. Difficulty adjusting schedule to allow for new tasks or unexpected events. May be able to complete consistent routines on time once the routine has been learned. Difficulty determining the priority of smaller tasks or the steps needed to complete larger long term tasks. Metacognition Metacognition is the ability to take an overall view of yourself in a given situation (the ability to take a bird s eye look at a situation and your place in it). Metacognition also enables an individual to observe and then think about the solution to a given task, problem or situation. Possible Signs of the Dysfunction of the Executive Skill of Metacognition May make careless mistakes or fail to check work. Difficulty recognizing there is a problem. Failing to ask for help when there is a problem. Finds it difficult to evaluate their own performance. May be unable to recognize how their behavior affects the situation, others or themselves. Asks for help with a task rather than problem solving on their own. Unable to understand that a task or problem may have more than one solution. May avoid tasks or activities that involve problem solving. Goal Directed Persistence Goal directed persistence refers to an individual s ability to complete goals that they set for themselves or that are set for them by others (parents, teachers, etc.). Possible Signs of the Dysfunction of the Executive Skill of Goal Directed Persistence Starts tasks but does not follow through and finish. May not continue with tasks/situations that are challenging. Difficulty sustaining attention to completing tasks. May not return to a task if interrupted before completing the task. 25

29 Secondary Concerns When discussing Fetal Alcohol Spectrum Disorders (FASD), primary disabilities are those caused by brain damage both structural and functional. Secondary concerns are those difficulties that an individual is not born with but which may result from having an FASD. Not every individual born with an FASD will have a secondary concern. In fact, there are several protective factors which can help prevent secondary concerns. It is important to note that not everyone diagnosed with FASD will be affected by any of the secondary concerns discussed here. However, it is possible that an individual with an FASD will have more than one secondary concern. The statistics used in this article were the result of a study by Dr. Ann Streissguth and her colleagues published in 1996 and contained the book The Challenge of Fetal Alcohol Syndrome: Overcoming Secondary Disabilities. Mental Health Problems Affected more than 90% of the individuals in Streissguth s study and more than 80% had received treatment for mental health problems. The study found no difference in the prevalence of mental health problems in children, adolescents and adults. Commonly diagnosed mental health problems in individuals with an FASD include Anxiety Disorders, Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Depression, Psychosis, and Suicide Threats or Attempts. Disrupted Schooling Of the adolescents and adults in Streissguth s study, more than 60% had a history of a disrupted school experience. 14% of the children in the study had their schooling disrupted. The most frequent disruption to school experience was suspension. The most common causes of disrupted schooling are Suspensions, 26

30 Expulsions, and Dropping Out. There are certain behaviors associated with FASD which may result in school disruptions. These behaviors include Disrupting Class, Disobedience, Disrespect - toward teachers or others in positions of authority, Learning Difficulties - especially when they are not properly diagnosed or addressed, Social Difficulties - especially relating to peers, and Truancy. Alcohol or Drug Use In general, alcohol and drug use are not a secondary concern for children. Up to 35% of individuals with an FASD will struggle with alcohol or drug use at some point in their life. More than half of those will require inpatient treatment. Legal Difficulties 60% of adolescents and adults with an FASD have legal difficulties which place them in the judicial system. Surprisingly, 14% of children with an FASD also have legal difficulties. Individuals who do not have disrupted school experiences are 40% less likely to have legal difficulties. The most frequent legal issues individuals with an FASD encounter are Assault, Crimes against Persons, Crimes against Property, Domestic Violence, Running Away, and Shoplifting. Confinement Of adolescents and adults with an FASD, 50% have experienced some form of confinement. Only 10% of children with an FASD have faced confinement. Adolescents and adults are more likely to have been incarcerated than to have be confined in another environment. The types of confinement being discussed here are Incarceration, In-Patient Alcohol Treatment, 27

31 In-Patient Drug Treatment, and In-Patient Mental Health Treatment. Inappropriate Sexual Behavior Inappropriate sexual behavior is exhibited by 49% of adolescents and adults with an FASD and 39% of children with an FASD. Types of inappropriate sexual behavior displayed include Compulsions, Inappropriate Sexual Advances, Inappropriate Sexual Touching, Obscene Telephone Calls, Promiscuity, and Voyeurism. Dependent Living Independent living is the goal for most individuals. However, 80% of adults with an FASD are living dependently. Dependent living may mean living with family members or in a setting such as a group home. Difficulty with Employment About 80% of adults with an FASD have difficulty with employment. This difficulty may be in getting a job or in keeping a job. None of these secondary concerns exist in a vacuum. Disrupted school experiences can result from learning disabilities, impulse control or a mental health disorder. Inappropriate sexual behavior may result from the poor judgment and lack of impulse control associated with FASD. Individuals with an FASD tend to be more easily persuaded or manipulated which may lead them into alcohol and drug use.legal problems can stem from alcohol and drug use. Not every individual with an FASD will experience these secondary concerns. However, it may be possible for several of these secondary concerns to affect the life of a person with an FASD. While it may seem that these secondary concerns would be difficult to prevent, there are several protective factors which can lead to lower rates of secondary concerns. Early Diagnosis The earlier a child is diagnosed with an FASD, the earlier interventions can begin. Involvement in Special Education and Social Services Special education can address the unique needs of children with an FASD. The brain damage caused by prenatal alcohol exposure can lead to learning difficulties and 28

32 challenging behaviors which special educators are trained to address. Early involvement with special education can help prevent the secondary concern of disrupted school experiences. Families of children with an FASD who access social services tend to have more positive outcomes. Social services that may be helpful include counseling - family, individual, stress management, etc. - and respite care. Loving, Nurturing and Stable Caretaking Environment All children benefit from a loving and nurturing environment. However, children with an FASD may enjoy more benefits from such an environment. Individuals with an FASD may be more sensitive to disruptions to their normal routine, transient living situations and harmful relationships. Living in a stable, loving environment may help individuals with an FASD avoid secondary concerns. Absence of Violence This protective factor relates closely to a loving, nurturing and stable caretaking environment. Individuals with an FASD who live in an environment without violence are less likely to become involved in violent activities. Secondary concerns can pose serious difficulties for individuals with an FASD and their families. It is important to remember that not every person with an FASD will be affected by any of these secondary concerns. The protective factors can help eliminate the presence and severity of secondary concerns. 29

FASD in Context: Substance Abuse Treatment. Minnesota Organization on Fetal Alcohol Syndrome (MOFAS) Fetal Alcohol Spectrum Disorders (FASD)

FASD in Context: Substance Abuse Treatment. Minnesota Organization on Fetal Alcohol Syndrome (MOFAS) Fetal Alcohol Spectrum Disorders (FASD) Minnesota Organization on Fetal Alcohol (MOFAS) Our mission is to eliminate disability caused by alcohol consumption during pregnancy and to improve the quality of life for those living with Fetal Alcohol

More information

Full Circle Advertising: A Look at Teen Alcohol Use and Fetal Alcohol Syndrome

Full Circle Advertising: A Look at Teen Alcohol Use and Fetal Alcohol Syndrome Full Circle Advertising: A Look at Teen Alcohol Use and Fetal Alcohol Syndrome Sherri Garcia Seabury Hall, Makawao, Hawaii In collaboration with Elizabeth Parra Dang, National Center on Birth Defects and

More information

Pregnancy and Substance Abuse

Pregnancy and Substance Abuse Pregnancy and Substance Abuse Introduction When you are pregnant, you are not just "eating for two." You also breathe and drink for two, so it is important to carefully consider what you put into your

More information

Individuals Affected by Fetal Alcohol Spectrum Disorder (FASD) and Their Families: Prevention, Intervention and Support

Individuals Affected by Fetal Alcohol Spectrum Disorder (FASD) and Their Families: Prevention, Intervention and Support FETAL ALCOHOL SPECTRUM DISORDERS (FASD) Individuals Affected by Fetal Alcohol Spectrum Disorder (FASD) and Their Families: Prevention, Intervention and Support Claire D. Coles, PhD Emory University, School

More information

9/11/2013. Minnesota Organization On Fetal Alcohol Syndrome. Seeing the Hidden Disability & Improving Outcomes for Students Affected by FASD

9/11/2013. Minnesota Organization On Fetal Alcohol Syndrome. Seeing the Hidden Disability & Improving Outcomes for Students Affected by FASD Minnesota Organization On Fetal Alcohol Syndrome Seeing the Hidden Disability & Improving Outcomes for Students Affected by FASD Presented by, Barb Clark MOFAS Family Resource Coordinator Our mission is

More information

Minnesota Organization on Fetal Alcohol Syndrome

Minnesota Organization on Fetal Alcohol Syndrome Minnesota Organization on Fetal Alcohol Understanding Fetal Alcohol Spectrum Disorders in the Treatment Setting Sierra Asamoa-Tutu Program Coordinator and Trainer sierra@mofas.org MINNESOTA ORGANIZATION

More information

Alcohol and drugs Be proactive

Alcohol and drugs Be proactive Alcohol and drugs Be proactive PREGNANCY: a critical time to take care of yourself and your future baby Pregnant women must often change certain daily habits and are bombarded with recommendations from

More information

Fetal Alcohol Spectrum Disorders 5-Minute Presentation for Classroom or Public Meeting or Committee Presentation

Fetal Alcohol Spectrum Disorders 5-Minute Presentation for Classroom or Public Meeting or Committee Presentation The following notes can be printed and cut out to be used to guide your 5-minute speech. Fetal Alcohol Spectrum Disorders 5-Minute Presentation for Classroom or Public Meeting or Committee Presentation

More information

Important facts to remember

Important facts to remember Important facts to remember If you re pregnant or trying to get pregnant, or if you know someone who is, there are several important points to remember: See a healthcare professional regularly. Get plenty

More information

DEPARTMENT FOR COMMUNITIES FOETAL ALCOHOL SPECTRUM DISORDER (FASD) INFORMATION FOR PEOPLE WORKING WITH CHILDREN AND FAMILIES

DEPARTMENT FOR COMMUNITIES FOETAL ALCOHOL SPECTRUM DISORDER (FASD) INFORMATION FOR PEOPLE WORKING WITH CHILDREN AND FAMILIES DEPARTMENT FOR COMMUNITIES FOETAL ALCOHOL SPECTRUM DISORDER (FASD) INFORMATION FOR PEOPLE WORKING WITH CHILDREN AND FAMILIES FOREWORD I am pleased to provide you with this booklet which contains important

More information

Fetal Alcohol Syndrome: A Preventable Disorder. Laura McConahey. A Capstone Project submitted in partial fulfillment of the

Fetal Alcohol Syndrome: A Preventable Disorder. Laura McConahey. A Capstone Project submitted in partial fulfillment of the Running head: FETAL ALCOHOL SYNDROME i Fetal Alcohol Syndrome: A Preventable Disorder Laura McConahey A Capstone Project submitted in partial fulfillment of the requirements for the Master of Science Degree

More information

CLASS OBJECTIVE: What factors influence prenatal development? Test Your Knowledge! True or False? Is the prenatal environment that important??

CLASS OBJECTIVE: What factors influence prenatal development? Test Your Knowledge! True or False? Is the prenatal environment that important?? Life Span Development I Chapter 9 CLASS OBJECTIVE: What factors influence prenatal development? 1 Test Your Knowledge! True or False? Most babies are born healthy and most hazards can be avoided. TRUE!

More information

If you re with child, be without alcohol. No amount of alcohol is safe to drink during pregnancy.

If you re with child, be without alcohol. No amount of alcohol is safe to drink during pregnancy. Alcohol & Pregnancy If you re with child, be without alcohol. No amount of alcohol is safe to drink during pregnancy. www.withchildwithoutalcohol.com 3 Introduction Many things we hear about pregnancy

More information

Fetal Alcohol Spectrum Disorder (FASD)

Fetal Alcohol Spectrum Disorder (FASD) Fetal Alcohol Spectrum Disorder (FASD) What is Fetal Alcohol Spectrum Disorder (FASD)? There's a lot to know about Fetal Alcohol Spectrum Disorder, or FASD. Here are answers to some of the questions often

More information

3/31/2015. Objectives. Alcohol. Long term effects. Substance abuse increases the risk of: Substance Abuse in Pregnancy

3/31/2015. Objectives. Alcohol. Long term effects. Substance abuse increases the risk of: Substance Abuse in Pregnancy Objectives Substance Abuse in Pregnancy Basics of screening and counseling Minako Watabe, MD Obstetrics and Gynecology Ventura County Medical Center 1) Discuss the risks of alcohol, tobacco, and drug use

More information

Chapter 4: Eligibility Categories

Chapter 4: Eligibility Categories 23 Chapter 4: Eligibility Categories In this chapter you will: learn the different special education categories 24 IDEA lists different disability categories under which children may be eligible for services.

More information

Child Development. Caseworker Core Training Module VII: Child Development: Implications for Family-Centered Child Protective Services

Child Development. Caseworker Core Training Module VII: Child Development: Implications for Family-Centered Child Protective Services Child Development P R E - T R A I N I N G A S S I G N M E N T Caseworker Core Training Module VII: Child Development: Implications for Family-Centered Child Protective Services Developed by the Institute

More information

Practice Test for Special Education EC-12

Practice Test for Special Education EC-12 Practice Test for Special Education EC-12 1. The Individualized Educational Program (IEP) includes: A. Written evaluation B. Assessment tests C. Interviews 2. Learning disabilities include: A. Cerebral

More information

Cerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments.

Cerebral palsy can be classified according to the type of abnormal muscle tone or movement, and the distribution of these motor impairments. The Face of Cerebral Palsy Segment I Discovering Patterns What is Cerebral Palsy? Cerebral palsy (CP) is an umbrella term for a group of non-progressive but often changing motor impairment syndromes, which

More information

ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR

ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR ARTICLE #1 PLEASE RETURN AT THE END OF THE HOUR Alcoholism By Mayo Clinic staff Original Article: http://www.mayoclinic.com/health/alcoholism/ds00340 Definition Alcoholism is a chronic and often progressive

More information

Alcohol Screening and Brief Interventions of Women

Alcohol Screening and Brief Interventions of Women Alcohol Screening and Brief Interventions of Women Competency #2 Midwest Regional Fetal Alcohol Syndrome Training Center Competency 2: Screening and Brief Interventions This competency addresses preventing

More information

Fetal Alcohol Spectrum Disorder in New Zealand: Activating the. Awareness and Intervention Continuum

Fetal Alcohol Spectrum Disorder in New Zealand: Activating the. Awareness and Intervention Continuum Fetal Alcohol Spectrum Disorder in New Zealand: Activating the Awareness and Intervention Continuum Executive Summary April 2007 This Alcohol Healthwatch briefing paper contains information on: Fetal Alcohol

More information

DISABILITY-RELATED DEFINITIONS

DISABILITY-RELATED DEFINITIONS DISABILITY-RELATED DEFINITIONS 1. The Americans with Disabilities Act (ADA) of 1990 is a civil rights law, which makes it unlawful to discriminate on the basis of disability. It covers employment in the

More information

during pregnancy. [4]

during pregnancy. [4] Center for Health Policy RESEARCH FOR A HEALTHIER INDIANA June 2012 Prenatal Alcohol Use and Fetal Alcohol Spectrum Disorder in Indiana Maternal alcohol use during pregnancy can have deleterious effects.

More information

An overview of Intellectual Developmental Disability Functioning levels of Mental Retardation/Intellectual Disability Autism

An overview of Intellectual Developmental Disability Functioning levels of Mental Retardation/Intellectual Disability Autism An overview of Intellectual Developmental Disability Functioning levels of Mental Retardation/Intellectual Disability Autism Intellectual/Developmental Disability (IDD) - indicates an overall intellectual

More information

UCLA Screening and Brief Intervention Training

UCLA Screening and Brief Intervention Training UCLA Screening and Brief Intervention Training For Alcohol Reduction or Cessation Client Centered Care Western Regional Training Center on Fetal Alcohol Spectrum Disorders Materials provided through funding

More information

Do you drink or use other drugs? You could be harming more than just your health.

Do you drink or use other drugs? You could be harming more than just your health. Do you drink or use other drugs? You could be harming more than just your health. Simple questions. Straight answers about the risks of alcohol and drugs for women. 1 Why is my health care provider asking

More information

Documentation Requirements ADHD

Documentation Requirements ADHD Documentation Requirements ADHD Attention Deficit Hyperactivity Disorder (ADHD) is considered a neurobiological disability that interferes with a person s ability to sustain attention, focus on a task

More information

Alcohol and Brain Damage

Alcohol and Brain Damage Alcohol and Brain Damage By: James L. Holly, MD O God, that men should put an enemy in their mouths to steal away their brains! That we should, with joy, pleasance, revel, and applause, transform ourselves

More information

A Guide for Enabling Scouts with Cognitive Impairments

A Guide for Enabling Scouts with Cognitive Impairments A Guide for Enabling Scouts with Cognitive Impairments What cognitive impairments are discussed in this manual? Autism Spectrum Disorder Attention Deficit Hyper Activity Disorder Depression Down Syndrome

More information

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010 Extended MPH Degree Program School of Public Health Department of Epidemiology University of Washington Epidemiology 521 Epidemiology of Maternal and Child Health Problems Winter / Spring, 2010 Instructor:

More information

3030. Eligibility Criteria.

3030. Eligibility Criteria. 3030. Eligibility Criteria. 5 CA ADC 3030BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS Barclays Official California Code of Regulations Currentness Title 5. Education Division 1. California Department

More information

Statement for the Record. Mr. Chairman and Members of the Committee:

Statement for the Record. Mr. Chairman and Members of the Committee: The Need For National Cerebral Palsy Surveillance - Testimony before the House Subcommittee on Labor, Health and Human Services, Education, and Related Agencies - Committee on Appropriations Dr. Janice

More information

Influences on Birth Defects

Influences on Birth Defects Influences on Birth Defects FACTS About 150,000 babies are born each year with birth defects. The parents of one out of every 28 babies receive the frightening news that their baby has a birth defect There

More information

Genetic Aspects of Mental Retardation and Developmental Disabilities

Genetic Aspects of Mental Retardation and Developmental Disabilities Prepared by: Chahira Kozma, MD Associate Professor of Pediatrics Medical Director/DCHRP Kozmac@georgetown.edu cck2@gunet.georgetown.edu Genetic Aspects of Mental Retardation and Developmental Disabilities

More information

non-specificity. FASD, short of full FAS, requires documentation of prenatal alcohol exposure.

non-specificity. FASD, short of full FAS, requires documentation of prenatal alcohol exposure. Encyclopedia of Drugs, Alcohol & Addictive Behavior, 3rd Edition, Vol 2 - Finals/10/13/2008 19:50 PM Page 155 non-specificity. FASD, short of full FAS, requires documentation of prenatal alcohol exposure.

More information

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures by R. Louise Floyd, DSN, RN; Brian W. Jack, MD; Robert Cefalo, MD, PhD; Hani Atrash, MD, MPH; Jeanne Mahoney, BSN,

More information

Diagnosis and Intervention Strategies for Fetal Alcohol Syndrome Children and Adolescents:

Diagnosis and Intervention Strategies for Fetal Alcohol Syndrome Children and Adolescents: Diagnosis and Intervention Strategies for Fetal Alcohol Syndrome Children and Adolescents: Perspectives from (Neuro)Psychology Anne Uecker PhD Child Neuropsychologist Edmund N Ervin Pediatric Center MaineGeneral

More information

Fact Sheet. Fetal Alcohol Spectrum Disorder: The effect of alcohol on early development

Fact Sheet. Fetal Alcohol Spectrum Disorder: The effect of alcohol on early development Fact Sheet Fetal Alcohol Spectrum Disorder: The effect of alcohol on early development It s like my brain s not in the same order as everybody else s. It s like I m wired differently. Young man with Fetal

More information

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities

Comprehensive Special Education Plan. Programs and Services for Students with Disabilities Comprehensive Special Education Plan Programs and Services for Students with Disabilities The Pupil Personnel Services of the Corning-Painted Post Area School District is dedicated to work collaboratively

More information

Relationship Between Child Abuse, Substance Abuse and Violence

Relationship Between Child Abuse, Substance Abuse and Violence Relationship Between Child Abuse, Substance Abuse and Violence Native American Population (All Ages) Leads nation in death caused by: alcohol-related motor vehicle fatalities chronic liver disease and

More information

Epilepsy 101: Getting Started

Epilepsy 101: Getting Started American Epilepsy Society 1 Epilepsy 101 for nurses has been developed by the American Epilepsy Society to prepare professional nurses to understand the general issues, concerns and needs of people with

More information

The Thirteen Special Education Classifications. Part 200 Regulations of the Commissioner of Education, Section 4401(1)

The Thirteen Special Education Classifications. Part 200 Regulations of the Commissioner of Education, Section 4401(1) The Thirteen Special Education Classifications Part 200 Regulations of the Commissioner of Education, Section 4401(1) Student With a Disability: A student as defined in section 4401(1), who has not attained

More information

Developmental Disabilities

Developmental Disabilities RIGHTS UNDER THE LAN TERMAN ACT Developmental Disabilities Chapter 2 This chapter explains: - What developmental disabilities are, - Who is eligible for regional center services, and - How to show the

More information

Cerebral Palsy. In order to function, the brain needs a continuous supply of oxygen.

Cerebral Palsy. In order to function, the brain needs a continuous supply of oxygen. Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Up to 5000 children in the United States are diagnosed with cerebral palsy every year. This reference

More information

Women in Recovery Summits: A Targeted Strategy to Prevent Fetal Alcohol Spectrum Disorders (FASD)

Women in Recovery Summits: A Targeted Strategy to Prevent Fetal Alcohol Spectrum Disorders (FASD) Women in Recovery Summits: A Targeted Strategy to Prevent Fetal Alcohol Spectrum Disorders (FASD) Kathleen Tavenner Mitchell, M.H.S., L.C.A.D.C. Vice President and Spokesperson National Organization on

More information

Cerebral Palsy. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com nr200105 Last reviewed: 06/17/2014 1

Cerebral Palsy. 1995-2014, The Patient Education Institute, Inc. www.x-plain.com nr200105 Last reviewed: 06/17/2014 1 Cerebral Palsy Introduction Cerebral palsy, or CP, can cause serious neurological symptoms in children. Thousands of children are diagnosed with cerebral palsy every year. This reference summary explains

More information

65G-4.014 Eligibility for Agency Services Definitions. (1) Autism means any condition which is part of the autism spectrum disorder and which meets

65G-4.014 Eligibility for Agency Services Definitions. (1) Autism means any condition which is part of the autism spectrum disorder and which meets 65G-4.014 Eligibility for Agency Services Definitions. (1) Autism means any condition which is part of the autism spectrum disorder and which meets the requirements of Florida Statute 393.063, which are

More information

American Society of Addiction Medicine

American Society of Addiction Medicine American Society of Addiction Medicine Public Policy Statement on Women, Alcohol and Other Drugs, and Pregnancy Background The American Society of Addiction Medicine (ASAM) is deeply committed to the prevention

More information

Melissa A. Knott Fairleigh Dickinson University

Melissa A. Knott Fairleigh Dickinson University 32 Fetal Alcohol Syndrome Diagnosis and Treatment: A Current Literature Review Melissa A. Knott Fairleigh Dickinson University Many children suffer with the effects of fetal alcohol syndrome (FAS). These

More information

Addressing Substance Use in Pregnancy

Addressing Substance Use in Pregnancy Addressing Substance Use in Pregnancy Stefan Maxwell, MD Director, NICU, CAMC Women and Children s Hospital Chair, Drug Use in Pregnancy Committee West Virginia Perinatal Partnership July 31, 2013 WV Early

More information

The Health Index: Tracking Public Health Trends in London & Middlesex County

The Health Index: Tracking Public Health Trends in London & Middlesex County FETAL ALCOHOL SPECTRUM DISORDER (FASD): ALCOHOL CONSUMPTION DURING PREGNANCY, AWARENESS AND ATTITUDES IN LONDON AND MIDDLESEX COUNTY Issue 16, May 2005 KEY POINTS A recent amendment to the Liquor License

More information

The MSACD Prevention Program serves as the state expert on Fetal Alcohol Syndrome (FAS) and other drug related birth defects.

The MSACD Prevention Program serves as the state expert on Fetal Alcohol Syndrome (FAS) and other drug related birth defects. P R E V E N T I O N Examples of prevention activities conducted by the MSACD Prevention Program include: The MSACD Prevention Program serves as the state expert on Fetal Alcohol Syndrome (FAS) and other

More information

a guide to understanding moebius syndrome a publication of children s craniofacial association

a guide to understanding moebius syndrome a publication of children s craniofacial association a guide to understanding moebius syndrome a publication of children s craniofacial association a guide to understanding moebius syndrome this parent s guide to Moebius syndrome is designed to answer questions

More information

National Association for Children of Alcoholics. Social Work Initiative

National Association for Children of Alcoholics. Social Work Initiative National Association for Children of Alcoholics Social Work Initiative Introduction To Working With Children Of Parents With Substance Use Disorders Shelly A. Wiechelt, Ph.D. University of Maryland, Baltimore

More information

Learning Disabilities, Behavioral/Emotional Disorders, and Other Brain Disorders: What We Know

Learning Disabilities, Behavioral/Emotional Disorders, and Other Brain Disorders: What We Know Learning Disabilities, Behavioral/Emotional Disorders, and Other Brain Disorders: What We Know by Ted Schettler, MD There are many ways that something can go awry in the brain, which can impair our ability

More information

Family Counseling Center Children s Questionnaire (to age 10) For Parent/Guardian to Complete. Child s Name: DOB: Age:

Family Counseling Center Children s Questionnaire (to age 10) For Parent/Guardian to Complete. Child s Name: DOB: Age: Family Counseling Center Children s Questionnaire (to age 10) For Parent/Guardian to Complete Child s Name: DOB: Age: School: Grade: Race/Ethnic Origin: Religious Preference: Family Members and Other Persons

More information

FAQ' s on Alcohol Abuse and Alcoholism

FAQ' s on Alcohol Abuse and Alcoholism FAQ' s on Alcohol Abuse and Alcoholism It is important to understand that these answers are not meant to provide specific medical advice, but to provide information to better understand the health consequences

More information

Indian health service 2015 National Behavioral Health Conference Behavioral Health Integration with Primary Care

Indian health service 2015 National Behavioral Health Conference Behavioral Health Integration with Primary Care Indian health service 2015 National Behavioral Health Conference Behavioral Health Integration with Primary Care Presentation 1: Fetal Alcohol Syndrome Update Elise Leonard, MD Chief of Mental Health,

More information

Cerebral Palsy: Intervention Methods for Young Children. Emma Zercher. San Francisco State University

Cerebral Palsy: Intervention Methods for Young Children. Emma Zercher. San Francisco State University RUNNING HEAD: Cerebral Palsy & Intervention Methods Cerebral Palsy & Intervention Methods, 1 Cerebral Palsy: Intervention Methods for Young Children Emma Zercher San Francisco State University May 21,

More information

Drug Abuse and Addiction

Drug Abuse and Addiction Drug Abuse and Addiction Introduction A drug is a chemical substance that can change how your body and mind work. People may abuse drugs to get high or change how they feel. Addiction is when a drug user

More information

Member Messenger NORTH CAROLINA SERVICE CENTER COMMERCIAL DIVISION ANNUAL BEHAVIORAL HEALTH QUALITY MANAGEMENT GUIDE

Member Messenger NORTH CAROLINA SERVICE CENTER COMMERCIAL DIVISION ANNUAL BEHAVIORAL HEALTH QUALITY MANAGEMENT GUIDE Member Messenger NORTH CAROLINA SERVICE CENTER COMMERCIAL DIVISION ANNUAL BEHAVIORAL HEALTH QUALITY MANAGEMENT GUIDE Quality Program Structure, Operations and Initiatives ValueOptions is always working

More information

Special Education Coding Criteria 2012/2013. ECS to Grade 12 Mild/Moderate (including Gifted and Talented) Severe

Special Education Coding Criteria 2012/2013. ECS to Grade 12 Mild/Moderate (including Gifted and Talented) Severe Special Education Coding Criteria 2012/2013 ECS to Grade 12 Mild/Moderate (including Gifted and Talented) Severe Special Education Coding Criteria 2012/2013 ISSN 1911-4311 Additional copies of this handbook

More information

Substance-Exposed Newborns

Substance-Exposed Newborns Substance-Exposed Newborns State of Oklahoma 2013 Substance-Exposed Newborns State of Oklahoma 2013 Legal Background Federal guidelines in the Child Abuse Prevention and Treatment Act (CAPTA) require states

More information

Traumatic Brain Injury

Traumatic Brain Injury Traumatic Brain Injury NICHCY Disability Fact Sheet #18 Updated, July 2014 Susan s Story Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her

More information

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease.

Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Steps to getting a diagnosis: Finding out if it s Alzheimer s Disease. Memory loss and changes in mood and behavior are some signs that you or a family member may have Alzheimer s disease. If you have

More information

Facts About Alcohol. Addiction Prevention & Treatment Services

Facts About Alcohol. Addiction Prevention & Treatment Services Facts About Alcohol Addiction Prevention & Treatment Services Table of Contents Facts about alcohol: What is harmful involvement with alcohol?... 2 What is alcohol dependence?... 3 What Is BAC?... 4 What

More information

Alcohol and Reproduction

Alcohol and Reproduction The facts about... Alcohol and Reproduction Five key things you need to know Even small amounts of alcohol can interfere with our reproductive systems. The more you drink, the greater the effect it can

More information

Underage Drinking. Underage Drinking Statistics

Underage Drinking. Underage Drinking Statistics Underage Drinking Underage drinking is a serious public health problem in the United States. Alcohol is the most widely used substance of abuse among America s youth, and drinking by young people poses

More information

Child Abuse and Neglect AAP Policy Recommendations

Child Abuse and Neglect AAP Policy Recommendations Child Abuse and Neglect AAP Policy Recommendations When Inflicted Skin Injuries Constitute Child Abuse Committee on Child Abuse and Neglect PEDIATRICS Vol. 110 No. 3 September 2002, pp. 644-645 Recommendations

More information

BABIES BORN TO ADDICTED MOTHERS

BABIES BORN TO ADDICTED MOTHERS BABIES BORN TO ADDICTED MOTHERS PATRICA M. MESSERLE LICENSED CLINICAL PSYCHOLOGIST, M.A., ABSNP LICENSED SCHOOL PSYCHOLOGIST DIPLOMATE OF THE AMERICAN BOARD OF SCHOOL- NEUROPSYCHOLOGY 1 Signs and Symptoms

More information

The National Survey of Children s Health 2011-2012 The Child

The National Survey of Children s Health 2011-2012 The Child The National Survey of Children s 11-12 The Child The National Survey of Children s measures children s health status, their health care, and their activities in and outside of school. Taken together,

More information

Cerebral palsy, neonatal death and stillbirth rates Victoria, 1973-1999

Cerebral palsy, neonatal death and stillbirth rates Victoria, 1973-1999 Cerebral Palsy: Aetiology, Associated Problems and Management Lecture for FRACP candidates July 2010 Definitions and prevalence Risk factors and aetiology Associated problems Management options Cerebral

More information

ALCOHOL. A Women s Health Issue

ALCOHOL. A Women s Health Issue ALCOHOL A Women s Health Issue U.S. DEP AR TMEN T OF HEAL TH AND HUMAN SER VICES National Institutes of Health National Institute on Alcohol Abuse and Alcoholism This booklet is the result of a collaboration

More information

STAFF DEVELOPMENT in SPECIAL EDUCATION

STAFF DEVELOPMENT in SPECIAL EDUCATION STAFF DEVELOPMENT in SPECIAL EDUCATION Learning Disabilities AASEP s Staff Development Course LEARNING DISABILITIES Copyright AASEP (2006) 1 of 7 Objectives To understand what is a learning disability

More information

Developmental delay and Cerebral palsy. Present the differential diagnosis of developmental delay.

Developmental delay and Cerebral palsy. Present the differential diagnosis of developmental delay. Developmental delay and Cerebral palsy objectives 1. developmental delay Define developmental delay Etiologies of developmental delay Present the differential diagnosis of developmental delay. 2. cerebral

More information

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH.

ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. ALCOHOLISM, ALCOHOL DEPENDENCE AND THE EFFECTS ON YOUR HEALTH. Alcoholism also known as alcohol dependence is a disabling ADDICTIVE DISORDER. It is characterized by compulsive and uncontrolled consumption

More information

Optional Tests Offered Before and During Pregnancy

Optional Tests Offered Before and During Pregnancy Plano Women s Healthcare Optional Tests Offered Before and During Pregnancy Alpha-Fetoprotein Test (AFP) and Quad Screen These are screening tests that can assess your baby s risk of having such birth

More information

DRUG AND ALCOHOL POLICY

DRUG AND ALCOHOL POLICY DRUG AND ALCOHOL POLICY Pace University seeks to promote individual wellness in as many ways as possible. Accordingly, in summary, the Policy prohibits the unlawful use, possession, sale, distribution,

More information

WIC HEALTH AND BEHAVIOR WORKBOOK

WIC HEALTH AND BEHAVIOR WORKBOOK WIC HEALTH AND BEHAVIOR WORKBOOK This workbook is based on research protocols tested in Project CARE funded by NIAAA (R01#AA12480) and the Office of Research on Minority Health (ORMH). Nutritionist's Copy

More information

Supporting children and families affected by Fetal Alcohol Spectrum Disorders (FASD)

Supporting children and families affected by Fetal Alcohol Spectrum Disorders (FASD) Supporting children and families affected by Fetal Alcohol Spectrum Disorders (FASD) Vicki Russell, Sara McLean, Stewart McDougall Please note: The views expressed in this webinar are those of the presenters,

More information

Facts on. Mental Retardation NATIONAL ASSOCIATION FOR RETARDED. 2709 Avenue E East P.O. Box 6109 Arlington, Texas 76011

Facts on. Mental Retardation NATIONAL ASSOCIATION FOR RETARDED. 2709 Avenue E East P.O. Box 6109 Arlington, Texas 76011 Facts on Mental Retardation NATIONAL ASSOCIATION FOR RETARDED CHILDREN 2709 Avenue E East P.O. Box 6109 Arlington, Texas 76011 This booklet was revised and updated in August, 1973 as part of an ongoing

More information

Dr. John Carosso, Psy.D Psychologist Autism Center of Pittsburgh

Dr. John Carosso, Psy.D Psychologist Autism Center of Pittsburgh Dr. John Carosso, Psy.D Psychologist Autism Center of Pittsburgh Evaluation Date: Client Information Child s Name: Date of Birth: Age: Male Female Eye Color Ethnicity: Insurance: Primary _ ID # Grp # Card

More information

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following the experience or witnessing of a

More information

Section 15.3 Long-Term Risks of Alcohol

Section 15.3 Long-Term Risks of Alcohol Objectives Identify five serious physical effects of longterm alcohol abuse. Describe the three stages of alcoholism. List in order three steps taken during recovery from alcoholism. Slide 1 of 25 Myth

More information

SOCIAL AND DEVELOPMENTAL HISTORY. School Attending: Grade: Date of Birth: Telephone: Home: Work: Cell:

SOCIAL AND DEVELOPMENTAL HISTORY. School Attending: Grade: Date of Birth: Telephone: Home: Work: Cell: SOCIAL AND DEVELOPMENTAL HISTORY Student s Name: First Middle Last Male Female School Attending: Grade: Date of Birth: Parent s Names: Address: Telephone: Home: Work: Cell: Parent email address: Legal

More information

Alcohol Facts and Statistics

Alcohol Facts and Statistics Alcohol Facts and Statistics Alcohol Use in the United States: Prevalence of Drinking: In 2012, 87.6 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime;

More information

Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families

Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families Towards Developing a Manual for Residential Treatment Centers to Support Individuals with an FASD and Their Families Presented By Dr. Pamela Gillen University of Colorado Anschutz Medical Campus and Dan

More information

Health Science / Anatomy Exam 1 Study Guide

Health Science / Anatomy Exam 1 Study Guide THIS EXAM WILL ONLY COVER ALCOHOL AND TOBACCO LECTURES Alcohol What is Alcohol? Alcohol is a depressant Contains intoxicating substance called ethyl alcohol or ethanol Alcohol use Approximately 59.8% of

More information

On behalf of the Association of Maternal and Child Health Programs (AMCHP), I am

On behalf of the Association of Maternal and Child Health Programs (AMCHP), I am Christopher Kus, M.D., M.P.H. Association of Maternal and Child Health Programs, Public Witness Testimony House Labor, Health and Human Services and Education Appropriations Subcommittee March 13, 2013

More information

GETTING RESULTS. fact sheet. California Youths and Alcohol Use Strategies for Parents and Schools to Take Action. How Does Alcohol Impact Youths?

GETTING RESULTS. fact sheet. California Youths and Alcohol Use Strategies for Parents and Schools to Take Action. How Does Alcohol Impact Youths? GETTING RESULTS fact sheet Jack O Connell, State Superintendent of Public Instruction California Department of Education, Sacramento, 2007 California Youths and Alcohol Use Strategies for Parents and Schools

More information

PUBLIC HEALTH IMPROVEMENT PARTNERSHIP

PUBLIC HEALTH IMPROVEMENT PARTNERSHIP PUBLIC HEALTH IMPROVEMENT PARTNERSHIP PUBLIC HEALTH ACTIVITIES & SERVICES INVENTORY TECHNICAL NOTES HEALTHY FAMILY DEVELOPMENT Nurse-Family Partnership Nurse-Family Partnership is a voluntary program of

More information

Fetal Alcohol Spectrum Disorders Distance Courses

Fetal Alcohol Spectrum Disorders Distance Courses Fetal Alcohol Spectrum Disorders Distance Courses The Arctic FASD RTC is offers a series of three, intensive, one-credit courses during the spring semesters through distance delivery via the Department

More information

2) Recurrent emotional abuse. 3) Contact sexual abuse. 4) An alcohol and/or drug abuser in the household. 5) An incarcerated household member

2) Recurrent emotional abuse. 3) Contact sexual abuse. 4) An alcohol and/or drug abuser in the household. 5) An incarcerated household member Co Occurring Disorders and the on Children: Effectively Working with Families Affected by Substance Abuse and Mental Illness Definition (Co-Occurring also called Dual Dx) A professional diagnosis of addictive/substance

More information

California Society of Addiction Medicine (CSAM) Consumer Q&As

California Society of Addiction Medicine (CSAM) Consumer Q&As C o n s u m e r Q & A 1 California Society of Addiction Medicine (CSAM) Consumer Q&As Q: Is addiction a disease? A: Addiction is a chronic disorder, like heart disease or diabetes. A chronic disorder is

More information

Traumatic Brain Injury and Incarceration. Objectives. Traumatic Brain Injury. Which came first, the injury or the behavior?

Traumatic Brain Injury and Incarceration. Objectives. Traumatic Brain Injury. Which came first, the injury or the behavior? Traumatic Brain Injury and Incarceration Which came first, the injury or the behavior? Barbara Burchell Curtis RN, MSN Objectives Upon completion of discussion, participants should be able to Describe

More information

Traumatic Brain Injury

Traumatic Brain Injury Traumatic Brain Injury NICHCY Disability Fact Sheet #18 Resources updated, March 2011 Susan s Story Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She

More information

Key Facts about Influenza (Flu) & Flu Vaccine

Key Facts about Influenza (Flu) & Flu Vaccine Key Facts about Influenza (Flu) & Flu Vaccine mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching

More information

Depiction Suggestions

Depiction Suggestions Chapter 23 Women and Addiction The following points for consideration on the portrayal of women and addiction were developed as a resource for entertainment development and production. They are not meant

More information

What You Don t Know Can Harm You

What You Don t Know Can Harm You A L C OHOL What You Don t Know Can Harm You National Institute on Alcohol Abuse and Alcoholism National Institutes of Health U.S. Department of Health and Human Services If you are like many Americans,

More information